Addressing the chronic pain-early cognitive decline comorbidity among older adults; The Active Brains study

解决老年人慢性疼痛-早期认知能力下降的合并症；

• 批准号: 10558586
• 负责人: Christine S Ritchie
• 金额: $ 59.47万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-02-01 至 2027-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10558586
• 关键词: Address; Adherence; Alzheimer disease prevention; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Anxiety; Awareness; Behavior; Benchmarking; Brain; Breathing; Bypass; Cellular Phone; Clinical Trials; Cognition; Cognitive; Consent; Coping Skills; Data; Data Collection; Education; Educational process of instructing; Elderly; Emotional; Enrollment; Ethnic Origin; Evidence based program; Evidence based treatment; Exercise; Funding; General Hospitals; Geriatrics; Goals; Health; Hip region structure; Impaired cognition; Individual; Infrastructure; Intervention; Interview; Investigation; Link; Massachusetts; Measures; Mediating; Mediator; Mental Depression; Methodology; Methods; Modeling; National Center for Complementary and Integrative Health; Neurobehavioral Manifestations; Outcome; Pain; Pain intensity; Pain management; Participant; Patient Self-Report; Patients; Performance; Persistent pain; Pharmaceutical Preparations; Physical Function; Population; Psychology; Race; Randomized; Reaction; Reporting; Respiratory Diaphragm; Scanning; Single-Blind Study; Strategic Planning; Stress and Coping; Technology Assessment; Testing; Walking; Wrist; acceptability and feasibility; actigraphy; active control; adverse event risk; barrier to care; battery life; blind; chronic musculoskeletal pain; chronic pain; chronic pain management; clinical predictors; clinically relevant; cognitive benefits; cognitive function; cognitive performance; cognitive reserve; comorbidity; digital; digital monitoring; disability; effective intervention; efficacy evaluation; efficacy testing; emotional functioning; ethnic minority; experience; falls; feasibility trial; fitbit; follow-up; functional improvement; high risk population; improved; intervention delivery; mind/body; mindfulness; monitoring device; multidisciplinary; multimodality; normal aging; novel; pain catastrophizing; pain symptom; participant retention; pre-clinical; primary outcome; programs; racial minority; recruit; reinforcer; response; secondary outcome; side effect; skills; slow potential; theories; uptake; virtual; virtual delivery

PROJECT SUMMARY Chronic pain and early cognitive decline are increasingly prevalent among older adults, bidirectionally related, and individual risk factors for Alzheimer’s Disease and Related Dementias (ADRD). Chronic pain and cognitive decline exacerbate each other, placing individuals on a “disability spiral” or worsened physical, emotional, and cognitive functioning with incremental risk of ADRD. Currently there are no evidence-based treatments that successfully address the chronic pain-early cognitive decline comorbidity among older adults. With funding from NCCIH and NIA we used mixed methods to iteratively develop a multimodal, theory grounded, group-based mind-body activity program tailored to the unique needs of older adults with chronic pain and early cognitive decline. The program helps older adults manage pain, increase cognitive reserves, and increase engagement in activities that are meaningful to them using quota-based pacing reinforced by a digital monitoring device. The program shows excellent feasibility and acceptability for virtual delivery and remote data collection. Program participation is associated with improvement in multimodal physical function (self-report, 6-minute walk test and Actigraph measured stepcount), emotional function (depression and anxiety), cognitive function (self-report and objective), pain intensity and theory informed mediators. Building on our promising study we now propose to conduct a fully powered RCT of our mind-body activity program (Active Brains-Digital) versus an educational control (Health Enhancement Program) both delivered virtually among N=260 older adults with musculoskeletal chronic pain and early cognitive decline. We will establish efficacy of Active Brains-Digital, sustainability of improvement over 6 months, and mechanisms of change through relevant mediators and moderators. The trial will take place at the Massachusetts General Hospital using our established methodology and infrastructure. Active Brains-Digital has the potential to be the first evidence-based program for older adults with chronic pain and early cognitive decline, with important implications for prevention of AD/ADRD in this high risk population. This project directly aligns with NIA strategic Goal C, objectives 1 and 3.

项目摘要 慢性疼痛和早期认知能力下降越来越普遍，双向相关，并且 阿尔茨海默氏病和相关痴呆症（ADRD）的个体危险因素。慢性疼痛和认知 拒绝彼此加剧，使个人陷入“残疾螺旋”或身体，情感和情绪恶化和恶化 认知功能具有ADRD的增量风险。目前尚无基于证据的治疗 解决老年人的慢性疼痛认知能力下降。从NCCIH的资金和 nia我们使用混合方法迭代地发展了多模式，理论基于群体的思维体活动 根据慢性疼痛和早期认知能力下降的老年人的独特需求量身定制的计划。该程序有帮助 老年人管理疼痛，增加认知储量并增加对他们有意义的活动的参与 使用数字监控设备加强基于配额的起搏。该程序显示出极好的可行性和 虚拟交付和远程数据收集的可接受性。计划参与与改进有关 多模式的身体功能（自我报告，6分钟的步行测试和Actigraph测量的步骤），情感功能 （抑郁和动画），认知功能（自我报告和客观），疼痛强度和理论知情人士。 在我们的承诺研究的基础上，我们现在建议进行全力以赴的活动计划 （活跃的大脑数字）与教育控制（健康增强计划）几乎在 n = 260名肌肉骨骼慢性疼痛和早期认知能力下降的老年人。我们将确定主动的效率 大脑数字，6个月内改善的可持续性以及通过相关调解人和变化的机制 主持人。该试验将使用我们既定的方法论在马萨诸塞州总医院进行， 基础设施。活跃的大脑 - 数字有可能成为第一个基于证据的计划 慢性疼痛和早期认知能力下降，对预防AD/ADRD的重要意义 人口。该项目直接与NIA战略目标C，目标1和3保持一致。